Cai Xiahong, Guo Yunkai
Department of Otorhinolaryngology, the Third Hospital of Yueyang City, Yueyang 414000.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2002 Nov;16(11):581-3.
To study the clinical features, diagnosis and management of nose and nasal sinuses fungus.
Different manner of surgical procedure was taken according to the areas and degree of pathological changes. The patients with noninvasive fungus were treated with radical maxillary sinusotomy (cald-well-Luc operation) or endoscopic sinus surgery. The patients with invasive form were undergone by the sinusotomy of enlarging areas, and combined with a postoperatively antifungal therapy.
Twenty-six patients were involved in noninvasive fungus, and 25 cases in them were cured in single surgery through different manner. Nine patients were in invasive one, and 7 in them were also cured by single surgery in different manner. One patient with invasive fungus died 5 months postoperatively for extensive area and non effective treatment although four surgical excisions were done.
CT scan is very important in their diagnosis, and the histopathology leads to identification of the fungus. Surgical removal is a radical kind of treatment. It is essential to excise and open entirely the involved sinus cavity whatever type,and to enlarge areas for the extensive invasive fungus.
研究鼻及鼻窦真菌病的临床特征、诊断及治疗方法。
根据病变范围及程度采取不同的手术方式。非侵袭性真菌病患者采用上颌窦根治术(柯-陆氏手术)或鼻内镜鼻窦手术。侵袭性真菌病患者行扩大范围的鼻窦切开术,并术后联合抗真菌治疗。
非侵袭性真菌病患者26例,其中25例经不同方式单次手术治愈。侵袭性真菌病患者9例,其中7例也经不同方式单次手术治愈。1例侵袭性真菌病患者尽管行4次手术切除,但因病变范围广泛及治疗无效,术后5个月死亡。
CT扫描对其诊断非常重要,组织病理学检查有助于真菌的鉴定。手术切除是一种根治性治疗方法。无论何种类型,彻底切除并开放受累鼻窦腔,对于广泛侵袭性真菌病应扩大手术范围至关重要。